Delayed feedback enhances learning performance in individuals with traumatic brain injury, study indicates

The goal of this study was to assess the effects of delayed vs. immediate performance feedback on learning in individuals with TBI and to examine the associated brain networks. The findings revealed that delayed feedback led to better learning performance compared to immediate feedback or no feedback at all. This finding also suggests that delayed feedback may engage brain regions responsible for memory retrieval and confidence.

Foundation authors from the Center for Traumatic Brain Injury Research include Ekaterina Dobryakova, PhD, Tien T Tong, PhD, Olesya Iosipchuk, Anthony Lequerica, PhD, Veronica Schneider, Nancy Chiaravalloti, PhD, joined by Joshua Sandry, PhD, Psychology Department, Montclair State University.

"The observed results might be explained by delayed feedback processing circumventing the striatal dopaminergic regions of the brain responsible for learning from immediate feedback that are impaired in TBI," said lead author Dr. Dobryakova, assistant director, Neuroscience Research at the Foundation. The study also showed that participants had higher confidence in their learning performance during delayed feedback trials, supported by increased brain activity in the superior parietal and angular gyrus -- areas linked to successful memory retrieval and higher memory confidence.

Twenty-eight participants with moderate-to-severe TBI participated in a paired-associate word learning task while undergoing magnetic resonance imaging (MRI). Feedback was presented either immediately, after a delay, or not at all, with behavioral and brain imaging data revealing the advantages of delayed feedback. The main measures included learning performance accuracy, confidence ratings, a post-task questionnaire, and blood oxygen level-dependent signal.

"While the majority of existing studies have focused on immediate feedback, the impact of delayed feedback on learning is understudied. Prior research has demonstrated that learning from immediate and delayed feedback employed distinct brain regions in healthy individuals," explained Dr. Dobryakova. "Our study suggests that, in individuals with TBI, delayed feedback may be a valuable tool for improving learning outcomes by engaging brain regions associated with memory retrieval and confidence, thereby bypassing the impaired immediate feedback processing pathways."

This research was supported by This work was supported by The New Jersey Commission on Brain Injury Research [grant number CBIR17PIL022).